免疫检查点抑制剂在既往放射领域复发宫颈癌患者中的活性:临床和免疫组织化学调查

IF 3.7 2区 医学 Q1 OBSTETRICS & GYNECOLOGY
Seiji Mabuchi, Naoko Komura, Harumi Nakamura, Michihide Maeda, Takeshi Yokoi, Shinsuke Koyama, Tomoko Ueda
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引用次数: 0

摘要

目的:研究免疫检查点抑制剂(immune checkpoint inhibitors, ICIs)在不同部位宫颈癌患者中的疗效,探讨ICIs敏感性差异的机制,重点关注CD8+ T淋巴细胞和程序性死亡配体1 (programmed death-ligand 1, PD-L1)的表达。方法:回顾性分析2019年1月至2024年1月(临床队列)期间接受派姆单抗或西米单抗治疗的复发或转移性宫颈癌患者的临床资料。根据疾病发生地点对目标疾病进行分类:在先前辐照场内(场内疾病)、场外疾病和两者兼而有之。免疫组化研究使用配对肿瘤样本(即原发性宫颈肿瘤和确诊放疗后出现的局部复发肿瘤:免疫组化队列)。生存率采用Kaplan-Meier法估计,log-rank检验比较。结果:50例患者接受含派姆单抗的化疗(n=39)或西米单抗(n=11)进行评估。其中6例(12.0%)为单纯野内疾病,28例(56.0%)为野外疾病,其余16例(32%)为两种疾病兼有。田间病害的应答率明显低于田间病害(36.3% vs. 72.7%, p=0.004)。野内疾病患者的无进展生存期(p=0.003)和总生存期(p=0.003)明显短于野外疾病患者。田间疾病与肿瘤浸润性CD8+ T淋巴细胞和PD-L1表达降低有关。结论:与野外病变相比,野内宫颈癌复发与含icis化疗敏感性降低有关。肿瘤浸润性CD8+ T淋巴细胞和PD-L1表达降低可能是这种对含ici化疗敏感性差异的原因。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The activity of immune checkpoint inhibitors in patients with recurrent cervical cancer developed in previously irradiated field: clinical and immunohistochemical investigations.

Objective: We aimed to 1) evaluate the efficacy of immune checkpoint inhibitors (ICIs) in cervical cancer patients according to the site of disease, 2) investigate the mechanism responsible for differential ICIs sensitivities with focuses on CD8+ T lymphocytes and programmed death-ligand 1 (PD-L1) expression.

Methods: We retrospectively reviewed clinical data from patients with recurrent or metastatic cervical cancer treated with pembrolizumab or cemiplimab between January 2019 and January 2024 (clinical cohort). Target diseases were classified according to the site of diseases: within previously irradiated field (in-field diseases), out-of-field diseases, and both. Immunohistochemical investigations were performed using paired tumor samples (i.e. initial cervical tumor and locally-recurrent tumor developed after definitive radiotherapy: Immunohistochemical cohort). Survival rates were estimated using the Kaplan-Meier method and compared using the log-rank test.

Results: Fifty patients treated with pembrolizumab-containing chemotherapies (n=39) or cemiplimab (n=11) were assessed. Of these, six patients (12.0%) had in-field diseases alone, twenty-eight patients (56.0%) had out-of-field diseases, and the remaining sixteen (32%) patients had both types of diseases. In-field diseases demonstrated a significantly lower response rate compared to out-of-field diseases (36.3% vs. 72.7%, p=0.004). Patients with in-field diseases demonstrated significantly shorter progression-free survival (p=0.003) and overall survival (p=0.003) than those with out-of-field diseases. In-field diseases were associated with decreased tumor-infiltrating CD8+ T lymphocytes and PD-L1 expression.

Conclusion: In-field cervical cancer recurrence was associated with decreased sensitivity to ICIs-containing chemotherapies when compared to out-of-field diseases. Decreased tumor-infiltrating CD8+ T lymphocytes and PD-L1 expression are possible reasons for this differential sensitivity to ICI-containing chemotherapies.

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来源期刊
Journal of Gynecologic Oncology
Journal of Gynecologic Oncology ONCOLOGY-OBSTETRICS & GYNECOLOGY
CiteScore
6.00
自引率
2.60%
发文量
84
审稿时长
>12 weeks
期刊介绍: The Journal of Gynecologic Oncology (JGO) is an official publication of the Asian Society of Gynecologic Oncology. Abbreviated title is ''J Gynecol Oncol''. It was launched in 1990. The JGO''s aim is to publish the highest quality manuscripts dedicated to the advancement of care of the patients with gynecologic cancer. It is an international peer-reviewed periodical journal that is published bimonthly (January, March, May, July, September, and November). Supplement numbers are at times published. The journal publishes editorials, original and review articles, correspondence, book review, etc.
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